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Empowering Deaf Society - 2024
Events Registration Form
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Which event/service do you would like to attend ?
*
Apple Workshop (Every Thursday for 3 weeks) - Thursday, 28th November, 5th December and 12th December at 10 AM
Garden at 120 - Friday, 20th December at 3:30 PM
Deaf Euston Club- Friday, 10th January 2025 at 6pm -9pm
Jeff Wayne’s The War of the Worlds-Saturday, 25th January 2025 at 12 pm
Deaf Community Garden
Other:
First Name
*
Your answer
Last Name
*
Your answer
Middle Name if any
Your answer
Mobile
*
Your answer
Email
*
Your answer
Borough
*
Barking and Dagenham
Barnet
Bexley
Brent
Bromley
Camden
City of London
City of Westminster
Croydon
Ealing
Enfield
Greenwich
Hackney
Hammersmith and Fulham
Haringey
Harrow
Havering
Hillingdon
Hounslow
Islington
Kensington and Chelsea
Kingston upon Thames
Lambeth
Lewisham
Merton
Newham
Redbridge
Richmond upon Thames
Southwark
Sutton
Tower Hamlets
Waltham Forest
Wandsworth
Other
For healthy and safety & monitoring purpose we need your address. Are you happy to provide, please type down 'YES". If no, please type down 'NO' and tell us your reason
*
Your answer
Address
Your answer
Postcode
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Age Group
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0 - 5 years
6 - 10 years
11 - 17 years
18 - 25 years
26 - 34 years
35 - 44 years
45 and 55 years
55 and 65 years
65 and over
Prefer not to say
Gender
*
Female
Male
Transgender
Non-binary
Prefer not to say
Other
Sexual Orientation
*
Straight
Gay
Bisexual
Lesbian
Prefer not to say
Other
Ethnicity
*
Black
White
Asian
Mixed race
Prefer not to say
Other
Disability
*
Deaf
Hard of Hearing
Deafened
Deaf and Blind
Prefer not to say
None
Which EDS service would you like to access ?
Employment Support
Advocacy Support
Advice
BSL Courses (Level 1, 2, 3 and NVQ Level 6)
Deaf Awareness Training
BSL After School Club
None
Clear selection
Are you claiming any benefits? If yes, Please select from the following
*
PIP/DLA
Working Tax Credit
Housing Benefit
ESA
JSA
Universal Credit
Income Support
None
Other
Religions
*
No religion
Not prefer to say
Christian
Buddhist
Hindu
Jewish
Muslim
Sikh
Unknown
Other:
How did you find us ?
*
Facebook
Instagram
Twitter
Empowering Deaf Society
Google
Word of Mouth
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